School Refusal…?

John Taylor Gatto talks a lot about the fact that the U.S. Dept. of Education is a huge jobs project and one of the largest employers in the country. Try to reform the system, make it more efficient and you would cause a lot of people to lose their jobs. I’m beginning to think this extends to other professions as well, who make a good living off of all the syndromes and psychoses with which school children are diagnosed. I wrote a while ago about Preschool Depression. Well, yesterday the Times printed an article in its’ Health section titled, “When a Doctor’s Note for a Student Doesn’t Help”.
The subject of this article is something called ‘school refusal’. Pretty self-explanatory. A child does not want to go to school, so they have sore throats, a cough, whatever, and their parent takes them to the doctor. This article was written by one such pediatrician, who berates himself for not having recognized the ‘symptoms’ of school refusal in one patient, a first grader who was missing so many days that the school nurse called the pediatrician to say that the child was in danger of having to repeat the grade, and would he please make sure there was something really wrong with the boy.
There are so many disturbing things in this article that I hardly know where to begin, so I’m going to quote rather extensively from it before I comment. (Actually, I may comment on it as I go along – I doubt I can wait till the end.):

“School refusal – any kind of absenteeism, from phobia to truancy, that can be traced to the child’s own actions and wishes – is at the very intersection of education, psychology and pediatrics. So it should be a good place for teachers, psychologists and pediatricians to work together.”

Ok, stop right there for a minute. (See, told you I couldn’t wait.) So the problem begins when absenteeism is due to the child’s own actions and wishes. Yes, god forbid we give any credence to a child’s wishes. Bring on the psychologists! Children are not supposed to have wishes when it comes to school attendance. (I suspect that a majority of children would suffer from symptoms of ‘school refusal’ if given the option). Let’s continue.

“My patient was an anxious and somewhat quirky child — I had talked to his mother about the possibility of a developmental evaluation, but we had agreed to wait and watch him in first grade. In fact, he was avoiding things in school that made him uncomfortable — interactions on the bus, jostling on the playground. He was avoiding academic moments where someone might find out he was struggling. And he was sticking close to his mother, so she could keep an eye on him and he could keep an eye on her.”

I can’t decide if this part makes me want to laugh, or scream and throw things across the room. Probably the latter. The doctor thinks the 6 year old is ‘quirky’ and might require a developmental evaluation. Hmmm. So in the eyes of the doctor, this boy wasn’t doing things that ‘normal’ six year old boys should be doing. (Not even going to speculate what those things might be) Then it get’s better. The boy was AVOIDING THINGS THAT MADE HIM UNCOMFORTABLE! I’m sorry, but isn’t it normal for people to avoid things that make them uncomfortable? And what things was he avoiding? “Interactions” on the bus. Translation: kids grabbing his things and playing keep away, or teasing him. Also, ‘jostling on the playground’. Jostling? You mean, getting shoved around by older or bigger kids? Gee, why on earth would he try and avoid that? Or, “avoiding academic moments where someone might find out he was struggling.” I love how this guy says, ‘academic moments’. In real language, what that whole sentence means is getting called on by the teacher, not knowing the answer and having everyone else laugh at you.
So basically the kid was, in school vernacular, a sissy. Why he wasn’t clamoring to leave his mother and join the fun that was 1st Grade is not something for us lay-folk to figure out. Are there any ‘experts’ out there ready to weigh in?

“Dr. Helen Egger, a child psychiatrist and epidemiologist at Duke University Medical Center, has studied the relationship between school refusal and conditions like depression and anxiety disorder. About a quarter of the children in her study who showed school refusal behavior had anxiety problems. And as she told me, ‘it can be as strongly associated with depression as with anxiety.’”

A child psychiatrist tells us that some kids who don’t want to go to school do so because they are anxious. Really? Wow, I never would have thought of that. Some of them are even depressed. Can you imagine? Leaving the comfort and security of your home to go to a place where you are ridiculed for being different or getting an answer wrong can cause symptoms of depression? What else can the experts tell us? Well…

“As a developmental-behavioral pediatrician at Johns Hopkins, Dr. Barbara Howard sees the more extreme cases of school refusal…Some have difficulty from the first day of kindergarten because they aren’t ready to separate from their parents..she told me;… And when children are anxious about returning to school, she continued, it’s especially important to ask them whether there are particular problems — a bully, a bathroom with no doors on the stalls.”

I’m speechless. We need to pay people to tell us stuff like this?

“The taxonomy of school refusal — from school phobia to truancy — is complicated and has changed over time. Experts now tend to break down the behaviors by motivation.
Children may avoid school because they are trying to avoid negative feelings, like anxiety or depression, or negative experiences, like exams or troubling social interactions. On the other hand, they may be pursuing some positive reward — a parent’s attention, the chance to play video games all day or, for older kids, more illicit pleasures.”

So according to the ‘experts’, school phobia and truancy are two different things. Some kids are anxious about going, others just say ‘screw it – you can’t make me go’ and skip. I don’t think those two things are different at all. The only difference is the personality of the kid involved and how they deal with the fact that they really don’t want to be there. Avoid the negative, accentuate the positive; isn’t that what life coaches all over the place are telling people to do? Oh, I forgot. Kids aren’t really people. They shouldn’t be allowed to pursue positive rewards. (I love how it’s parental attention, video games or ‘illicit pleasures’, i.e. sex. Yep, want to avoid all three of those!)
The article then goes on to talk about using ‘anxiety management’ techniques, or, for those thrill-seeking truants out there, ‘increased incentives for going to school’. (No one mentions what those incentives might be, but as I mentioned in another post, here in New York they wanted to PAY kids for doing well on tests, so fill in the blanks yourselves on that one.)

“If we look at school as children’s work, then absenteeism becomes a kind of red flag, a signal that something has gone wrong in a child’s health or emotional life, or within the family or in the school itself….
‘It’s not a diagnosis, school refusal,’ Dr. Egger said, ‘It’s not a disorder; it’s a symptom.’ But it’s an important symptom, with consequences that can be harsh. It should send parents – and pediatricians, educators and psychologists – looking for ways to help.”

It’s true that sometimes when adults have problems in their personal lives, or health problems, their work suffers. Sometimes, however, it’s just that they despise the job they’re in and would rather be doing anything else. The difference is, adults can leave a job. I absolutely hate it when people call school a kid’s ‘job’. No it isn’t.
Maybe some of this ‘school refusal‘ is the result of emotional or health trauma outside the school, but I’d bet my life that is a minority percentage. I think the problem, which no one is willing to acknowledge, (as usual) is school itself. How about not making it mandatory for kids to go away from their parents all day every day at the age of 5? (Or 4 or 3 or 2, depending on the nursery/preschool they attend). How about acknowledging that school is a living hell for some kids? A hell not of their own making and from which they have no escape? Stop trying to put a nice name on it and wrap it in a package that can be neatly shipped off to some behavioral psychologist for analysis. I’m not naive enough to think that everyone will homeschool their children. I know that it is not possible for everyone. But can’t we begin to acknowledge that all these symptoms are not things we need psychologists and pediatricians to fix? The problem is not the kids, people. The problem is the situation the kids are forced into, against their will and without their consent.

But as Gatto said, change the educational system and a lot of people are going to lose their jobs. Including behavioral psychologists and child psychiatrists. And we can’t have that, now, can we?

About Amy

Amy Milstein was born and raised on a farm in Indiana, but after 20+ years considers herself a full-fledged New Yorker. She is married with two kids, who do not go to school but are instead life learners. This means they learn by living in the world (real life ) instead of hearing about it and simulating it in a classroom. With her family, Amy loves to travel, read, watch movies, write, sew, knit - the list is endless.